VA Boston Healthcare System, Psychology Service (116B), 940 Belmont Street, Brockton, MA 02310, USA.
Psychol Addict Behav. 2012 Jun;26(2):265-78. doi: 10.1037/a0025424. Epub 2011 Nov 7.
Historically, substance use problems were thought to be more prevalent in lesbian, gay, and bisexual (LGB) populations, and correcting skewed perceptions about substance abuse among LGB individuals is critically important. This review provides an update on empirical evidence on LGB substance use patterns and treatment outcome, with specific focus on clinical implications of findings. Compared to earlier studies, the recent research included in this review has used more sophisticated methodologies and more representative samples, and also has investigated multiple dimensions of sexual orientation in relation to substance use patterns. Findings from recent research suggest that lesbians and bisexual women are at greater risk for alcohol and drug use disorders and related problems, and that gay and bisexual men are at greater risk for illicit drug use and related problems. Several sociocultural factors have emerged as correlates of substance use patterns in LGB populations (e.g., affiliation with gay culture, HIV status), and several demographic characteristics (e.g., female, older age) do not appear to be as robust of protective factors against substance abuse for LGB individuals compared to heterosexual populations. Bisexual identity and/or behavior in particular seem to be related to increased risk for substance abuse. In terms of treatment outcome, limitations of extant research prevent conclusions about the relative impact of LGB-specific interventions, and further research that includes women and uses more equivalent comparison interventions is needed. Clinical implications of research findings are discussed for case identification, selection of treatment goals (e.g., moderation vs. abstinence), targets for intervention, and specific treatment modalities.
从历史上看，人们认为性少数群体（包括女同性恋、男同性恋和双性恋者）中更普遍存在物质使用问题，纠正对性少数群体中物质滥用的偏见是至关重要的。本综述提供了关于性少数群体物质使用模式和治疗结果的实证证据的最新情况，特别关注研究结果的临床意义。与早期研究相比，本综述中包含的最新研究使用了更复杂的方法和更具代表性的样本，并调查了与物质使用模式相关的多种性取向维度。最近研究的结果表明，女同性恋者和双性恋女性更有可能患上酒精和药物使用障碍及相关问题，而男同性恋者和双性恋男性更有可能使用非法药物和相关问题。一些社会文化因素已成为性少数群体物质使用模式的相关因素（例如，同性恋文化的认同、HIV 状况），而一些人口统计学特征（例如，女性、年龄较大）与异性恋人群相比，似乎不能作为性少数群体预防物质滥用的强有力保护因素。双性恋身份和/或行为似乎与物质滥用风险增加有关。就治疗结果而言，现有研究的局限性使得无法得出关于特定于性少数群体的干预措施相对影响的结论，需要进一步研究，包括女性，并使用更等效的比较干预措施。研究结果的临床意义讨论了案例识别、治疗目标的选择（例如，适度与禁欲）、干预目标和特定的治疗方式。
